经口气管切开套管堵管患儿使用 Passy-Muir 阀后，与呼吸相关的住院率降低。

Decrease in Respiratory Related Hospitalizations in Tracheostomy-Dependent Children Who Tolerate Passy-Muir Valve Use.

机构信息

Division of Pediatric Otolaryngology, Children's National Hospital, Washington, DC, USA.

Division of Otolaryngology, George Washington University, Washington, DC, USA.

出版信息

Ann Otol Rhinol Laryngol. 2021 Jun;130(6):623-628. doi: 10.1177/0003489420966612. Epub 2020 Oct 21.

DOI:10.1177/0003489420966612

PMID:33084350

Abstract

OBJECTIVE

To assess the effect of Passy-Muir Valve (PMV) tolerance on respiratory illness and respiratory related hospital admissions in tracheostomy-dependent children.

METHODS

Retrospective cohort study of 262 patients who underwent tracheostomy placement between 2012 and 2018 at a tertiary free-standing children's hospital. Outcome measures studied were number of reported upper respiratory infections and respiratory related hospitalizations per year (RRH/year).

RESULTS

About 135 (51.5%) tracheostomy-dependent children underwent PMV trials, and 106 (78.5%) of these children were able to tolerate PMV for at least 1 hour daily. When comparing children who tolerated PMV versus those who did not, the latter group had significantly higher rates of subglottic stenosis but no significant differences in RRH/year or average age. In those children who tolerated PMV and achieved routine use of PMV > 1 hour/day, an average of 1.14 RRH/year occurred prior to PMV tolerance, as compared with 0.57 RRH/year after PMV tolerance ( = .003). Multivariate analysis shows that in patients <2 years, there is a significant decrease in RRH/year after PMV tolerance is attained (1.53 vs 0.76, = .001), independent of indication for tracheostomy.

CONCLUSION

In tracheostomy-dependent children who tolerate PMV use routinely >1 hour/day there are decreased rates of respiratory related hospitalizations (RRH). Children <2 years of age have the most impact of RRH, with rates that are significantly lower with routine use of the PMV.

摘要

目的

评估 Passy-Muir 阀（PMV）耐受对依赖气管切开术的儿童呼吸道疾病和与呼吸道相关的住院的影响。

方法

这是一项回顾性队列研究，纳入了 2012 年至 2018 年期间在一家三级独立儿童医院接受气管切开术的 262 名患者。研究的结果测量指标为每年报告的上呼吸道感染次数和与呼吸道相关的住院次数（RRH/年）。

结果

约 135 名（51.5%）依赖气管切开术的患儿进行了 PMV 试验，其中 106 名（78.5%）患儿能够耐受 PMV 至少 1 小时/天。与能够耐受 PMV 的患儿相比，不能耐受 PMV 的患儿下呼吸道狭窄的发生率显著更高，但 RRH/年或平均年龄无显著差异。在能够耐受 PMV 并实现常规使用 PMV>1 小时/天的患儿中，在 PMV 耐受之前，RRH 平均为每年 1.14 次，而在 PMV 耐受之后，RRH 平均为每年 0.57 次（ = .003）。多变量分析显示，在<2 岁的患者中，PMV 耐受后 RRH 显著减少（1.53 与 0.76， = .001），这与气管切开术的适应证无关。